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Welcome to hyoid’s page.
Contributor score: 40

Comments ...

 +1  (nbme24#21)
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nCa oonemse ealnpxi htis oen––I tidd'n lylear nwko tahw ot kmae fo eth bla elayClr ehs was agintk oto uhcm ilnn,sui utb hwo nca uoy eanieertftfdi titaifocsu doersrid rmof a pyte 1 citediba ohw kstea oot hcum fo tihre lisuinn e?osd

m-ice  I think the trick here is that they don't mention that the daughter has a history of Type 1 DM, so she has no reason to be taking insulin at all. She's definitely receiving insulin, but we don't have any history implying she's a type 1 diabetic. That, combined with the fact that there have been multiple episodes like this one, favors that the mother is giving the daughter insulin when she doesn't need it. +18
sajaqua1  C-peptide is produce by endogenous insulin, but is not part of exogenous insulin. She has elevated insulin, with low C-peptide, so she is receiving too much exogenous insulin. A history of recurrent episodes this year implies a behavioral issue; Factitious disorder imposed on another (also called Munchausen syndrome by proxy). +7

Subcomments ...

submitted by wired-in(67),
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ecneaMiantn soed aufmolr is Css( × lC × tu)a ÷ F

whree ssC si adeat-ysetst tgarte amplas ocn.c of u,dgr lC is lceacrne,a tua is odgesa nlavriet a;&pm F si ta.ibbvayoiliali

erheNit gasode erivntal onr ilitbivilbaaaoy si ngvi,e os rnogniig tseho &ma;p gunglipg in eht ernsmub lc(fearu to cvotrne intsu ot m)gya/dg:k/

=(12 muLg/ × 1 1mg0/00 )gu × .(009 kL//hrg × 1000 L1m/ L × 24 r1h/ yd)a
= .5229 g/gda/kym

.hhiw.c. n'sti any of eth naswer eihccso ltd.esi eyTh sumt haev ddnreuo 9.00 hrg//Lk to .01 r/L/h,gk nad ngiod os svgie ytcaelx 88.2 daggmy//k coe(hci )C

lispectedwumbologist  That's so infuriating I stared at this question for 20 minutes thinking I did something wrong +69  
hyoid  ^^^^^ +11  
seagull math never worked either. I also just chose the closest number. also, screw this question author for doing that. +9  
praderwilli  Big mad +9  
ht3  this is why you never waste 7 minutes on a question.... because of shit like this +8  
yotsubato  Why the FUCK did they not just give us a clearance of 0.1 if they're going to fuckin round it anyways... +18  
bigjimbo  JOKES +1  
cr  in ur maths, why did u put 24h/1day and not 1day/24h? if the given Cl was 0.09L/hr/kg. I know it just is a math question, but i´d appreciate if someone could explain it. +1  
d_holles  LMAO games NBME plays +2  
hyperfukus  magic math!!!!! how TF r we supposed to know when they round and when they don't like wtf im so pissed someone please tell me step isn't like this...with such precise decimal answers and a calculator fxn you would assume they wanted an actual answer! +1  
jean_young2019  OMG, I've got the 25.92 mg/kg/day, which isn't any of the answer choices listed. So I chose the D 51.8, because 51.8 is double of 25.9......I thought I must have make a mistake during the calculation ...... +6  
atbangura  They purposely did that so if you made a mistake with your conversion like I did, you might end up with 2.5 which was one of the answer choices. SMH +3  
titanesxvi  I did well, but I thought that my mistake was something to do with the conversion and end up choosing 2.5 because it is similar to 25.92 +2  
makinallkindzofgainz  The fact that we pay these people 60 dollars a pop for poorly formatted and written exams boggles my mind, and yet here I am, about to buy Form 24 +15  
qball  Me after plugging in the right numbers and not rounding down : +1  
frustratedllama  Not only do you feel like you're doing sth wrong but then that feeling stays for other questions. sucks so baad +  
fexx  'here.. take 50mg of vyvanse.. I just rounded it up from 30.. dw you'll be fine' (totally doing this with my patients 8-)) +1  
cbreland  I was so close to picking 2.5 because I thought I did a conversion error. 5 minutes later and still didn't feel comfortable picking 28.8😡 +  

submitted by medstruggle(12),
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Wyh si ti stuapohh lscreu if reteh rea no GI oyts?mpms hWy tac’n ti be rpseeh zeo?trs

colonelred_  It’s just canker sores, they come and go. I think in herpes the gingivostomatitis really only happens when you first get infected. After that you just get recurrent cold sores. +4  
hyoid  Herpes zoster is not the same as herpes simplex virus. +27  
bigjimbo  you would see dermatome rash in zoster +2  
kateinwonderland  cf) Just in case someone wanted to know the causative organism of aphthous ulcers :The precise cause of canker sores remains unclear, though researchers suspect that a combination of factors contributes to outbreaks, even in the same person. Unlike cold sores, canker sores are not associated with herpes virus infections. +8  
charcot_bouchard  Herpes Zoster doesnt cause gingivostomatitis. Herpengina can cause vesicular lesion in mouth but happens to children in summer season by entero virus +  
drdeeznuts1  I'm wondering if this could be a mild case of Behcet syndrome without genital involvement +  
sherry  It sure can be Behcet or Pemphigus if the q provides us with more info. Canker sores just come and go for years with unclear mechanism. Also herpes zoster is shingles by VZV, not HSV1. +1  
avocadotoast  Most pictures on google show herpangina being present on the hard palate/throat, while aphthous ulcers are commonly on the lower lip. I think his lack of genital lesions are pointing us away from herpangina. +  

submitted by welpdedelp(215),
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O,k os NAR tneepndde NDA oplysaerem is for sereevr r.ica.tar.esstnp sngeli taesdndr + eus RAN entpeeddn RAN plryaeems.o anC sooemen ?ipnexla

hyoid  The only thing I can think of is that HIV is a (+)-sense single-stranded RNA virus that relies on an RNA dependent DNA polymerase (reverse transcriptase) to synthesize DNA. +1  
haliburton  according to [medbullets link]( ns ss RNA must carry RNA dependent RNA polymerase (so that is out). also, according to medbullets there are very few ds RNA viruses, so "most likely" will be ss. Also, RNA-dependent DNA polymerase = Reverse Transcriptase. Since HIV is a ss ps RNA virus with RT, they've described an HIV cousin. not sure beyond this. +  
some0217710  Can’t think of any retroviruses outside of HIV and HTLV and they’re both +ssRNA +1